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全膝关节置换术后间断与持续引流的比较:一项荟萃分析。

Non-continuous versus continuous wound drainage after total knee arthroplasty: a meta-analysis.

机构信息

Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, People's Republic of China.

出版信息

Int Orthop. 2014 Feb;38(2):361-71. doi: 10.1007/s00264-013-2105-0. Epub 2013 Sep 19.

Abstract

PURPOSE

So far, controversy still exists regarding the use of non-continuous or continuous wound drainage after total knee arthroplasty. The aim of this study was to assess the efficacy and safety of these two drainage techniques after total knee arthroplasty.

METHODS

We searched the established electronic literature databases of Pubmed, Embase, Cochrane Library, CNKI, VIP and WANFANG. Nine RCTs including a total of 761 patients involving 811 knees were eligible for this meta-analysis.

RESULTS

Our results showed that non-continuous drainage was associated with less haemoglobin loss (WMD,  -0.43, 95 % CI -0.62 to -0.24; P < 0.00001) and postoperative visible blood loss (WMD,  -305.09, 95% CI -408.10 to -202.08; P < 0.00001) compared with continuous drainage. No significant difference was found between the two groups in terms of range of motion (WMD, 0.99, 95% CI -1.01 to 2.98; P = 0.33), incidence of blood transfusion (OR, 0.63, 95% CI 0.38 to 1.06; P = 0.80) or postoperative complications (OR, 1.09, 95% CI 0.35 to 3.40; P = 0.89).

CONCLUSION

The existing evidence indicates that non-continuous drainage can achieve less haemoglobin loss (especially the four- to six-hour drain clamping) and postoperative visible blood loss with no increased risk of postoperative complications compared with continuous drainage.

摘要

目的

迄今为止,全膝关节置换术后使用非连续或连续伤口引流仍存在争议。本研究旨在评估这两种引流技术在全膝关节置换术后的疗效和安全性。

方法

我们检索了 Pubmed、Embase、Cochrane 图书馆、CNKI、VIP 和 WANFANG 等已建立的电子文献数据库。共有 9 项 RCT 符合纳入标准,共纳入 761 例患者(811 膝)。

结果

我们的结果表明,与连续引流相比,非连续引流可减少血红蛋白丢失(WMD,-0.43;95%CI,-0.62 至-0.24;P<0.00001)和术后可见失血量(WMD,-305.09;95%CI,-408.10 至-202.08;P<0.00001)。两组在关节活动度方面无显著差异(WMD,0.99;95%CI,-1.01 至 2.98;P=0.33)、输血发生率(OR,0.63;95%CI,0.38 至 1.06;P=0.80)或术后并发症发生率(OR,1.09;95%CI,0.35 至 3.40;P=0.89)。

结论

现有证据表明,与连续引流相比,非连续引流可减少血红蛋白丢失(尤其是在四至六小时夹管时)和术后可见失血量,且术后并发症风险无增加。

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